結核
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
69 巻, 6 号
選択された号の論文の6件中1~6を表示しています
  • 馬場 治賢
    1994 年 69 巻 6 号 p. 387-396
    発行日: 1994年
    公開日: 2011/05/24
    ジャーナル フリー
    Preliminary studies showed that some strains of tubercle bacilli were inhibited even by2, μg/ml of rifampicin (RFP), but 10μg/ml or higher concentrations were needed for theinhibition of all strains. Of 5, 100 patients with pulmonary tuberculosis who were admittedto our hospital during 12 years since January 1970 through 1981, 1, 344 patients had noprevious antituberculous drug therapy. All of the strains of Mycobacterium tuberculosisisolated from such 1, 344 patients showed no or less than 10% growth of control on 10 μg-RFP medium by indirect susceptibility tests. But, I defined the clinically applicable criteriaof resistance to RFP as “more than 1 % growth of control on 10μg-RFP medium” becauseof following reasons: 1) the growth more than 1% and less than 10% of control on 10μg-RFP medium could be reasonably explained as the results of some technical failures, 2) theresults of follow-up observations of respective cases, 3) our previous studies on thedistribution of RFP-susceptibility of natural resistant strains.
    Among total 5, 100 cases, 605 cases had been treated with antituberculous drugspreviously but failed to achieve negative conversion of the bacilli, and restarted thetreatment with regimen including RFP (retreatment group), and the remains had noprevious treatment (initial treatment group). The negative conversion rates within threemonths of treatment were almost same (more than 95%) in both groups, but the rates ofRFP-resistance were 5.6% for the initial treatment group and 92.8 % for the retreatmentgroup.
  • 馬場 治賢
    1994 年 69 巻 6 号 p. 397-407
    発行日: 1994年
    公開日: 2011/05/24
    ジャーナル フリー
    The proportion method demands an exact count of the colonies on the control and drug- containning media to calculate an exact percentage of resistant bacilli among bacillipopulation.To realize this objective, the bacilli suspension must be fresh and homogeneous, susceptible and resistant bacilli must be equally distributed, each bacillus must be dispersedas a single cell when the bacilli suspension is diluted, colony count must be reduced at a ratepararell to the dilution.
    The critical concentration of each drug should essentially be determined in a clinicalmanner, however as the multi-drug combination therapy in the rule for the treatment oftuberculosis, it is very difficult to make an exact determination of the resistance to each ofdrugs.
    It may be better, as Canetti pointed out, to decide using the pure bacteriologicalmethod and later compare findings with clinical studies, making changes in the future if sorequired.
    We choose to follow their criteria for nearly all of the drugs making only a fewexceptions.
    1) SM: DH-SM is not available in Japan as Japanese government prohibits itsproduction. Growth on the medium containing SM (only concentration of less than 4μg/ml) was more abundant than on DH-SM media.
  • 安田 順一, 岡田 修, 栗山 喬之, 長尾 啓一, 山岸 文雄, 橋爪 一光, 鈴木 光
    1994 年 69 巻 6 号 p. 409-418
    発行日: 1994年
    公開日: 2011/05/24
    ジャーナル フリー
    For better understanding of pathophysiological aspects of tuberculosis sequelae, weinvestigated the relationship between pulmonary hemodynamics and chest X-ray findings.
    One hundred and seven patients with sequelae of pulmonary tuberculosis were examinedby the right cardiac catheterization, and pulmonary hemodynamic values were measured andcalculated.
    Chest X-ray findings were defined and classified into the following five items. The items were emphysematous change; fibrosis, bronchiectasis and/or cavity (hereafterabbreviated as “fibrosis”); pulmonary resection and/or atelectasis; pleural thickening;and thoracoplasty. The extent of each finding was defined.
  • 戸島 洋一, 浜岡 朋子, 藤田 明, 鈴木 光
    1994 年 69 巻 6 号 p. 419-424
    発行日: 1994年
    公開日: 2011/05/24
    ジャーナル フリー
    A 26year-old male who had been diagnosed as pulmonary tuberculosis three years agowith an antituberculous chemotherapy of only two months, complained of tiredness, exertional dyspnea and fever since a month ago. Bloody sputum, bloody stool andhematuria have developed three days before admission. Petechiae over the body trunk andlower extremities were observed on admission. Peripheral blood examination revealedlymphocytopenia (672/, μl), low hemoglobin content (6.2 g/dl), thrombocytopenia (3, 000/μ1), elevated FDP (36.2, μg/ml) and D-dimer (25.0 μg/ml) values. Chest radiograph showeda massive pleural effusion in the right hemithorax, bilateral pulmonary infitrates and acavity on CT scan. Together with positive acid-fast bacilli in sputum, diagnoses of relapsedpulmonary tuberculosis, tuberculous pleurisy associated with DIC (disseminated infravascular coagulation) were made. Left hydronephrosis which was presumed to be a consequence of infundibulum stenosis due to renal tuberculosis, was detected by abdominalultrasonography.
    Treatment with antituberculous drugs and protease inhibitors were started withthoracic tube drainage. DIC condition was improved by the 20 th hospital day and sputumculture turned to be negative after the 4 th week, however, fever up to 38°C continued untilthe end of the 7 th week and a D-dimer which is a representative marker for secondaryfibrinolysis, continuously showed a high level up to the 10 th week of hospitalization. Thepatient was uneventful during the three months follow up period after discharge.
  • 佐々木 結花, 山岸 文雄, 鈴木 公典, 杉戸 一寿, 杉本 尚昭, 庵原 昭一
    1994 年 69 巻 6 号 p. 425-429
    発行日: 1994年
    公開日: 2011/05/24
    ジャーナル フリー
    A case of multiple intracranial tuberculous nodule following miliary tuberculosis wasreported. The case was a 19-year-old woman visited a general practitioner, bacause offever. Chest x-ray film on the first visit showed diffuse granular shadows in her both lungswith pleural effusion in the left side. The case was diagnosed as bacterial pneumonia, andwas treated with antibiotics. She had been getting worse, and the doctor finally examinedher sputum, and tubercle bacilli were seen in her sputum (Gaffky 4) by the Ziehl Neelsen'sstaining. She was introduced to our hospital. Chest x-ray film on admission showed diffusegranular shadows in her both lungs and she was diagnosed her as miliary tuberculosis, andanti-tuberculous therapy was quickly started. She didn't complain of any neurologicaldisorders, but her brain CT showed several nodules in the left cerebral cortex enhanced withcontrast medium. Ti weighted MRI enhanced by Gd-DTPA revealed abnormal enhancements in the cerebrum, the cerebellum, and the midbrain. She was treated with antiepilepticdrugs, but after 65 days, she started to suffer from epileptic stroke. Six monthslater, her brain leisions have improved by the use of anti-tuberculosis drugs and antiepipleticdrugs. The incidence of tuberculosis has decreased in Japan, and, many doctors didnot show concern on, thus, a doctor's delay is a serious problem in Japan. Advocary showedbe made to doctors to detect tuberculous patients as early as possible.
  • 厚生省保健医療局エイズ結核感染症課編
    1994 年 69 巻 6 号 p. 459-461
    発行日: 1994年
    公開日: 2011/05/24
    ジャーナル フリー
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